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  • Management of Superficial Femoral Artery Occlusion by Subintimal Arterial Flossing with Antegrade Retrograde Intervention (Safari) Technique Through Transpopliteal Approach

    Hany Abdel Mawla Mohamed M.Sc, Maher Abd ElMoneim M.D, Mohamed EL-Maadawy M.D.
    Department of General Surgery, Faculty of Medicine, Cairo University

    Background: The subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique improves technical success when initial antegrade attempts at recanalization have failed .The retrograde approach is effective for successfull recanalization of chronic total occlusion of critical lower limb ischemia. Aim of the work. To assess the SAFARI Technique through transpopliteal approach to improve technical success for the performance of subintimal recanalization when there is failure to re-enter the distal true lumen or when there is a limited segment of patent distal target artery available for re-entry. Patients and Methods: The study was performed on 16 patients and 16 limbs with critical lower limb ischemia for whom percutaneous transluminal angioplasty has failed from antegrade approach then retrograde approach though transpopliteal access was used for recanalization. Results: By using SAFARI Technique,clinical success rate after the procedure which was detected by immediate regaining of the pulse or clinical improvement was 14 cases from 16 cases(87.5%). Conclusion: SAFARI TECHNIQUE is an ideal line of intervention in failure of re-entry of subintimal angioplasty or limited patent distal part of arterial tree. Key words: SAFARI-Transpopliteal -Recanalization –ISCHEMIA.